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CASE REPORT
Year : 2016  |  Volume : 17  |  Issue : 1  |  Page : 56-57

Woolly hair with trichoscopic features


Department of Dermatology, SDM College of Medical Sciences and Hospital, Sattur, Dharwad, Karnataka, India

Date of Web Publication4-Jan-2016

Correspondence Address:
Kikkeri Narayanshetty Naveen
Department of Dermatology, No. 10, Skin OPD, Sri Dharmasthala Manjunatheshwara College of Medical Sciences and Hospital, Sattur, Dharwad - 580 009, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2319-7250.172460

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  Abstract 

Woolly hair is the presence of more or less tightly coiled hair over the scalp of persons of non-African or Negroid background. A 3-year-old girl presented with woolly hair since birth. She had no other systemic abnormality. Trichoscopic examination of the scalp hairs revealed slight variation in the thickness of hair shafts, which was well visualized in an individual plucked hair. Broken hair shafts were visible. We are presenting this case due its sheer rarity and for its trichoscopy findings. Tricoscopy is better alternative than light microscopy for hair shaft abnormality as it allows visualizing multiple hairs without plucking it.

Keywords: Hair shaft, tricoscopy, woolly hair


How to cite this article:
Naveen KN, Shetty SR, Radha H, Athaniker SB, Gundannanavar MR. Woolly hair with trichoscopic features. Indian J Paediatr Dermatol 2016;17:56-7

How to cite this URL:
Naveen KN, Shetty SR, Radha H, Athaniker SB, Gundannanavar MR. Woolly hair with trichoscopic features. Indian J Paediatr Dermatol [serial online] 2016 [cited 2020 Jul 7];17:56-7. Available from: http://www.ijpd.in/text.asp?2016/17/1/56/172460


  Introduction Top


Woolly hair is the presence of more or less tightly coiled hair over the scalp of persons of non-African or Negroid background. It is a rare, congenital structural abnormality of scalp hair. The rate of hair growth is usually normal, but the anagen phase is truncated, resulting in shorter hair. The hair shaft exhibits elliptical cross-section, axial rotation, and kink formation.[1],[2]

Here, we are presenting a case of woolly hair with trichoscopic features.


  Case Report Top


A 3-year-old girl presented with discoloration and sparse hairs over the scalp since birth [Figure 1]. She is a product of Grade 2 consanguineous marriage. Her parents felt the hairs be unruly and hence attempted repeated tonsuring. In spite of this, the hair remained the same. Her developmental milestones were normal to her age. There were no similar complaints in the family members.
Figure 1: Woolly hair in the child

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Examination revealed light-colored hairs which were thinner, tightly coiled and curled. They were lusterless, sparse, short, and thinner in diameter. Skin and nails were normal, and there was no dental abnormality and palmoplantar keratoderma. There were no cardiac manifestations or any other systemic involvement. Based on the above findings, we arrived at a diagnosis of woolly hair. Hematological and biochemical parameters were also normal.

Trichoscopic examination of the scalp hairs revealed slight variation in the thickness of hair shafts, which was well visualized in an individual plucked hair [Figure 2] and [Figure 3]. Broken hair shafts were visible.
Figure 2: Trichoscopy showing a slight variation in the thickness of the shaft. Arrow mark showing the thinning of the shaft (×200)

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Figure 3: Trichoscopy of individual hair showing variation in the thickness of the shaft (×200)

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  Discussion Top


Woolly hair was first described by Gossage in 1907 in a European family. Woolly hair is extremely curly, with the average diameter of hair recorded up to a maximum of 0.5 cm. It is different from the curly hair of black people, in that the curled hair of black people lies separately while the curls of woolly hair usually merge.[2] Woolly hair was classified by Hutchinson et al.[3] into three variants: Hereditary woolly hair (autosomal dominant), familial woolly hair (autosomal recessive) and woolly hair nevus. Symmetrical circumscribed allotrichia is another variant. In the present case, there was no similar complaint in the family, so our patient could be an autosomal recessive variant without systemic involvement.

Naxos disease and carvajal disease are the two autosomal recessive disorders associated with woolly hair. Naxos disease is characterized by woolly hair, palmoplantar keratoderma and dilated cardiomyopathy with right ventricular dysplasia and it is due to mutation of plakoglobin gene. Carvajal disease is similar clinically to Naxos disease, except for left ventricular involvement and presentation at a younger age, and it is due to a mutation in the desmoplakin gene.[2]

Patil et al.[4] did trichoscopy on the woolly hair and demonstrated a “crawling snake” appearance of the hairs. They likened their appearance to the head of the mythical character Medusa. In our patient, the trichoscopy and individual hair under the light microscope showed a slight variation in the thickness of the shaft.

We are presenting this case due its sheer rarity and for its trichoscopy findings. Tricoscopy is better alternative than light microscopy for hair shaft abnormality as it allows visualizing multiple hairs without plucking it.

Declaration of Patient Consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial Support and Sponsorship

Nil.

Conflicts of Interest

There are no conflicts of interest.

 
  References Top

1.
Messenger AG, Berker DA, Sinclair RD. Disorders of Hair. In: Burns T, Breathnach S, Cox N, Griffiths C, editors. Rook's Textbook of Dermatology. Oxford: Wiley-Blackwell; 2010. p. 66.70-66.71.  Back to cited text no. 1
    
2.
Vasudevan B, Verma R, Pragasam V, Badad A. A rare case of woolly hair with unusual associations. Indian Dermatol Online J 2013;4:222-4.  Back to cited text no. 2
[PUBMED]  Medknow Journal  
3.
Hutchinson PE, Cairns RJ, Wells RS. Woolly hair. Clinical and general aspects. Trans St Johns Hosp Dermatol Soc 1974;60:160-77.  Back to cited text no. 3
[PUBMED]    
4.
Patil S, Marwah M, Nadkarni N, Gautam M, Godse K. The medusa head: Dermoscopic diagnosis of woolly hair syndrome. Int J Trichology 2012;4:184-5.  Back to cited text no. 4
    


    Figures

  [Figure 1], [Figure 2], [Figure 3]


This article has been cited by
1 Diagnosis of Woolly Hair Using Trichoscopy
Mahesh Mathur,Prakash Acharya,Alina Karki,Nisha KC,Jyoti Shah
Case Reports in Dermatological Medicine. 2019; 2019: 1
[Pubmed] | [DOI]



 

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